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NPI Code Detail

MEDICARE: MARA MAURER

MEDICARE:   MARA  MAURER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1396134813
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARA MAURER
Provider Business Mailing Address
First Line : 1704 E BROADWAY AVE
Second Line :
City : MARYVILLE
State : TN
Zip : 37804-2916
Country : US
Telephone Number : 865-681-6990
Fax Number :
Provider Business Practice Location Address
First Line : 1704 E BROADWAY AVE
Second Line :
City : MARYVILLE
State : TN
Zip : 37804-2916
Country : US
Telephone Number : 865-681-6990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2015
Last Update Date : 01/21/2015

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Directions to “ MARA MAURER ” Practice Location

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